Meta-analysis of histopathological outcomes of laparoscopic assisted rectal resection (LARR) vs open rectal resection (ORR) for carcinoma

Memon MA 1 , Awaiz A 2 , Yunus RM 3 , Memon B 4 , Khan S 5

Affiliations 

  • 1 South East Queensland Surgery (SEQS), Sunnybank Obesity Centre, Sunnybank, Queensland, Australia; School of Agricultural, Computing and Environmental Sciences, International Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Queensland, Australia; Mayne Medical School, School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Faculty of Health and Social Science, Bolton University, Bolton, Lancashire, UK. Electronic address: mmemon@yahoo.com
  • 2 South East Queensland Surgery (SEQS), Sunnybank Obesity Centre, Sunnybank, Queensland, Australia. Electronic address: aiman.awaiz@gmail.com
  • 3 Institute of Mathematical Sciences, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: rossita@um.edu.my
  • 4 South East Queensland Surgery (SEQS), Sunnybank Obesity Centre, Sunnybank, Queensland, Australia. Electronic address: bmemon@yahoo.com
  • 5 School of Agricultural, Computing and Environmental Sciences, International Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Queensland, Australia. Electronic address: Shahjahan.khan@usq.edu.au
Am J Surg, 2018 11;216(5):1004-1015.
PMID: 29958656 DOI: 10.1016/j.amjsurg.2018.06.012

Abstract

BACKGROUND: We conducted a meta-analysis of the randomized evidence to determine the relative merits of histopathological outcomes of laparoscopic assisted (LARR) versus open rectal resection (ORR) for rectal cancer.

DATA SOURCES: A search of PubMed and other electronic databases comparing LARR and ORR between Jan 2000 and June 2016 was performed. Histopathological variables analyzed included; location of rectal tumors; complete and incomplete TME; positive and negative circumferential resection margins (+/-CRM); positive distal resected margins (+DRM); distance of tumor from DRM; number of lymph nodes harvested; resected specimen length; tumor size and perforated rectum.

RESULTS: Fourteen RCTs totaling 3843 patients (LARR = 2096, ORR = 1747) were analyzed. Comparable effects were noted for all these histopathological variables except for the variable perforated rectum which favored ORR.

CONCLUSIONS: LARR compares favorably to ORR for rectal cancer treatment. However, there is significantly higher risk of rectal perforation during LARR compared to ORR.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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